Intensive Care

• There are nurses and doctors in the ICU, 24 hours a day, to talk to you.
• You can always approach any member of the team and ask for more information.
• The bedside nurse caring for your loved one usually has information about the patient’s condition.
• Doctors will be at the bedside during the patient’s admission to the unit, daily assessments, daily patient rounds, and in emergencies. These times are opportunities for quick updates only.
• For detailed discussions, it can be useful to schedule a meeting, when all members of the family can be present to discuss questions and decisions to be made.

We usually recommend having a nominated contact, who is responsible for communicating with the health-care team.

• The nominated contact (PDF, 500KB) can relay information to the entire family.
• This approach helps to ensure continuity of what every family member knows. When multiple people receive information at different times, it may lead to some confusion or misunderstandings.
• The nominated contact (PDF, 500KB) person is usually delegated by the family.

When several family members want a detailed update directly from the team, the best approach is to arrange a family meeting where everyone can be present.

It is sometimes difficult to know for sure if patients are aware of what’s going on around them, especially if they are not awake/sedated. However, it is important to treat all patients as if they can hear. Nurses always explain to each patient what is happening at the bedside before any care is provided.

Family members are encouraged to do the same. In fact, talking about the weather or activities at home may provide a familiar voice and added comfort for the patient.

Many patients in intensive care units are not capable of making decisions about treatments. To be “capable,” the patient must be able to understand the problem, the recommended treatment options, and the consequences of giving consent. If it is not immediately clear whether a patient is capable, special assessments or testing may be required.

Where a person is not competent to make an informed choice and give informed consent,and no person who is legally entitled to consent on the patient’s behalf is available,Right 7 (4) of the Code of Health and Disability Services Consumers’ Rights 1996 allows a healthcare provider to administer treatment. The principles of this right are:

1. Treatment is in the best interest of the patient;
2. Reasonable steps have been taken to ascertain the views of the patient;
3. If the patient’s views have not been ascertained, the healthcare provider takes into account the views of the other suitable persons who are available and interested in the welfare of the patient (eg. Family, whānau, regular caregivers, GP,  or others)

The suitable persons are not being asked to give informed consent.

Rather it is a matter of taking their views into account in deciding whether the proposed treatment is in the patient’s best interests and the patient would have consented.

Communicating with patients in the ICU can be difficult. Speech and language problems are often caused by strokes or other neurological conditions. Also, patients may not be able to use their voice to communicate if they are on a breathing machine.

Speech-language therapists are often called upon to evaluate the patient and find ways to establish communication if they are able.

• Sometimes simple tools, such as an alphabet board, can make a positive difference in a patient’s ability to communicate with family members and participate in their own medical care.
• By keeping communication as simple as possible, it can help avoid added frustration for the patient.
• Connecting with the patient may include just sitting at the bedside and holding his or her hand. A familiar face, touch, or voice can be comforting to the patient, reading to the patient or playing their favourite music.

It’s also important to allow for periods of rest for both the patient and family members. The bedside nurse can help provide some guidance about your loved one’s comfort and rest needs.

• Let the patient know you are there. Even if your loved one is not alert, a familiar voice can be comforting.
• Keep your conversation on subjects that will not upset the patient.
• Ask the nurse if you need help communicating with your loved one.
• Allow for the patient to express any concerns. Some topics might be upsetting, but avoiding them can create more stress. If you are not sure how to respond, ask advice from a member of the ICU team.
• You can bring items from home, such as family pictures, personal toiletries, a toy, or favourite blanket.
• You can provide hand massage.
• You can bring music and headphones. 
• You can ask your nurse for earplugs and an eye mask to help with patient's ability to sleep at night.
• If your loved one has been in ICU for a few days you can ask staff for a ‘patient diary’ that can be written in by family and friends and nursing staff to keep track of your loved one's progress. This diary is kept at the patient's bedspace for their entire stay.

In the first instance please talk to the ACNM / NIC or Doctor on duty.

If you don’t feel comfortable talking to them, engage with the Social Worker, or you can use the Nationwide Health & Disability Advocacy service by calling 0800 555 050 or emailing advocacy@advocacy.org.nz 

You can also read about how to use Kōrero mai – Talk to me: the patient and whānau/ family escalation of care process, this is detailed in our Patient and Visitor section.

You are invited to fill out a ‘Long term patient’ whiteboard on behalf of your loved one in which you can tell us things that are important to the patient. This information will help the staff to learn about what the patient likes to be called, the patient’s hobbies, favourite activities, and major achievements.

It is also important for us to know what cheers up or stresses out your loved one. You can also list things about the family and some of the supports the patient uses at home, such as glasses and hearing aid. Please ask the bedside nurse for a pen if you’d like to help fill this out.

The poster helps ICU clinicians to:

• Assess patients’ memory
• Orient the patient to familiar objects and people
• Address their comfort and preferences
• Acknowledge their unique personality and life experiences

The team may decide to move patients into different beds depending on the patient’s needs:

• Patients that require less intense support may be placed in beds close to each other, so one nurse can take care of them
• If strict isolation is required, patients may be moved to a closed room

Your loved one’s transfer may be unsettling for you because you are already familiar with the team and the location. But you can rest assured that all the information about your loved one will be properly communicated, and the same care will continue to be provided.

The daily patient round is the time when all clinicians (nurses, pharmacists, physicians, dietitians, physiotherapists, social workers and others) get together to discuss each patient individually in the handover room/ at the bedside, and make decisions about care and treatment.

• Daily rounds are led either by the attending staff intensivist or by the fellow
• By doing rounds every day, it helps provide better care to patients, and makes sure all the team members know what needs to be done.
• In teaching hospitals, rounds are also a learning opportunity for doctors-in-training.

You can ask anyone on the team to schedule a meeting. Your bedside nurse may be the best person to help you organise that.

You can schedule a private family meeting with the team whenever it is hard to understand what is going on, you are having difficulties making decisions, or you feel you can’t cope.

At family meetings, you will meet with the doctors and nurses taking care of your whanau, and other members of the team if needed.

• Sometimes the ICU team members will call you for a family meeting, especially if they think you may need help understanding and coping with what is going on.
• They may also request a meeting to get more information about the patient’s medical history, personality, values, and beliefs. This information could help shape the course of treatment.

Family meetings usually take place in a private room and are scheduled for a time when all participants can be present.

If you cannot be at the hospital in person, it is also possible to be updated by phone.

How do I prepare for a family meeting?

• Make sure the nurse has your correct telephone contact information.
• Obtain a pad of paper and consider keeping a note of the names of team members, key information you are told, and any questions you might have.
• Don’t be afraid to ask questions—any question you need answered is a good question.
• If the patient is not alert, be sure to share their wishes regarding surgery, life-supporting treatments and other interventions.
• It is good practice to learn more about your responsibilities in making decisions for your whanau member.

Some patients need help to breathe. In this situation a “breathing machine” – also known as a mechanical ventilator – is used to assist the function of the lungs.

• The ventilator blows air into the lungs, helping to maintain proper levels of oxygen in the blood.
• To use a mechanical ventilator, the medical team needs some form of access to the patient’s lungs.
• A tube can be inserted into the mouth or nose to reach the lungs. This is called intubation.
• Or, a tube can be inserted into the windpipe, medically known as the trachea. The procedure to create an opening in the windpipe is called a tracheostomy.

Mechanical ventilators are complex machines that can be adjusted to meet the needs of each patient.

• The most common adjustments will affect how much effort the patient needs to make, and how much oxygen is delivered.
• Adjustments are made fairly frequently throughout the day either by the medical team or under the instruction of the medical team to improve the patient’s comfort level and ensure proper oxygen levels in the blood.

Your first encounter with the team is at the moment of admission. This is often a very stressful time, especially if it is an emergency.

• Either a doctor or a nurse involved in the patient's care will provide you with an update as soon as the patient’s admission to the unit has been completed.
• At this early stage, many things you would like to know are uncertain, so the team members may not be able to answer all your questions.
• They will keep updating you frequently as things evolve.

As soon as a patient no longer needs ICU care, the team will put together a transfer plan. This will involve a patients Home Team (The Medical team taking of the care of a patient) where a comprehensive medical and nursing handover will be given to them.

The nurse at the bedside will inform you of the discharge plans.

The transfer to a ward of the hospital will occur once a patient no longer needs ICU care and monitoring. Although this is a sign the patient’s condition is improving, it may still be a stressful transition for the family.

Once on the ward, the ICU team will still be involved in their care, through the ICU Outreach Team, which is a group of critical-care specialists, such as nurses, and Doctors.

In the first 24 hours of being transferred to the ward, the Outreach Team will check-up on the patient’s progress either by looking at their observations remotely or formally checking in with a patient.

www.mylifeaftericu.com is a local website developed by The Australian and New Zealand Intensive Care Society (ANZICS).

The My Life After ICU website has some useful advice for ICU patients and their Whanau/carers, including information about:

• Adults in ICU 

• Children in PICU

• ICU and PICU beds interactive

• Support in New Zealand

If the patients condition is getting worse, the patients Home team will be first point of contact they may contact the Outreach Team to help manage the situation. The patient will be closely monitored, and new interventions may be started.

The goal is to improve the patient’s condition and avoid re-admission to Intensive Care. But, if necessary, the patient will be transferred back to the ICU.

An Intensive Care Specialist (ICU Consultant) is a medical specialist trained in comprehensive clinical management of critically ill patients. They are the leader of a multidisciplinary team.

Critically ill patients include patients with life-threatening, single and multiple organ system failure. Also, those at risk of clinical deterioration, and those requiring resuscitation and/or management in an intensive care unit or a high dependency unit.

The Intensive Care Specialist is primarily responsible for the care of a patient who is in the ICU. However, as patients’ medical conditions can be extremely complex, intensivists will always collaborate with other specialists who can provide consultation and help conduct medical investigations and treatments. For example,

• For patients with seizures, a Neurologist will be involved
• For patients with head trauma, a Neurosurgeon will be involved
• For patients requiring dialysis, a Nephrologist will be involved

The ICU intensivists will also work very closely with other physicians, who have been providing care before admission to the ICU. In the case of surgical or cancer patients, the intensivists will collaborate with the surgeons and oncologists (cancer doctors) who already know a patient, and therefore can provide important information about them.

Registrars: A Registrar is always present in the Intensive Care Unit and is supported by the Senior Medical Consultant. Registrars will review a patient multiple times over a 24-hour period.

ACNM/NIC (Associate Clinical Nurse Manager / Nurse in Charge are Senior registered nurses who have specialised in critical care. They have an overall view of the patients to manage flow and coordinate care.

Bedside nurses are registered nurses (RN), specialised in critical care so they can look after patients who are experiencing life-threatening health problems.

Their responsibilities include:

• Bedside nurses stay with your loved one for a 12-hour shift. In the ICU, each patient is usually assigned a nurse.
• The bedside nurse is also your main point of contact to provide an update on your loved one’s care and will help you reach out to the other members of the clinical team.
• Bedside nurses work with the team and are responsible for coordinating patient care.
• Bedside nurses are responsible for updating the medical team about any important changes in the patient’s condition.

The nursing team is also made up of Access Nurses who support the nurse at the bed side, Clinical Nurse support, Nurse Educator, Research Nurses, Health Care Assistance, and Student nurses.

Physiotherapists: During your stay in Intensive care, you will be seen and treated by a physiotherapist. They will provide physiotherapy for your loved one’s lungs and exercise limbs and muscles.

Speech and language Therapist: During your loved ones stay a therapist may assess their swallow ability or suggest a device to assist with speaking.

Dietitian: May be called on to assist with your loved one’s nutritional needs. Most of our patients are fed by a tube in their nose (nasogastric tube) or fed through a drip (intravenous cannula I.V.) straight into their vein.

Occupational Therapist: During your loved one’s stay, an occupational therapist might visit and assess your loved ones to help them regain skills, plan and direct therapy including physical and social activities.

Social Worker: We have Social workers who are available to support you and your loved one in crisis, they can talk to you about any problems, and help with accommodation, rights and financial enquiries.

Kaimahi Hauora Māori - Health Care Worker: Hauora Māori – Māori Health is about the wellbeing of te iwi Māori. There is a dedicated team of Māori and non- Māori health workers and registered health professionals who are responsive to Māori health needs. The service identifies cultural needs working with whānau , hapū and iwi and enables staff to access the support and resources available to meet their cultural needs.

What is respiratory failure?

Respiratory failure means that patients are unable to breathe normally on their own.

What complications can result from respiratory failure?

When patients are unable to breathe normally, the body may lack oxygen. They may also experience a build-up in their blood of carbon dioxide – a gas that is usually eliminated.

Low level of oxygen or high level of carbon dioxide can cause severe complications if not treated properly.

What can cause respiratory failure?

Many medical conditions can lead to respiratory failure.

Some of these conditions are directly related to the lungs, such as:

• Asthma
• Chronic Obstructive Pulmonary Disease (COPD)
• Pneumonia (lung infection)
• Pulmonary oedema (water on the lungs)

Other conditions leading to respiratory failure relate to other organs and systems of the body, such as:

• A failure of the nerves and muscles involved in breathing and coughing
• A life-threatening infection.

What can be done to help breathing?

When patients develop respiratory failure, they may require help to normalize the exchanges of oxygen and carbon dioxide in their body.

• Extra, or supplemental, oxygen can be given through nasal prongs or a mask. The treatment may be enough to correct low levels of oxygen for some patients
• When the respiratory failure is severe, a breathing machine (mechanical ventilation) is sometimes required.

How is the ventilator adjusted to meet the needs of the patient?

The ventilator has various settings that determine how much work the patient does and how much oxygen is given.

• It can be set to breathe entirely for the patient, by controlling how often the patient gets a breath and the size of each breath;
• It can also be set to allow the patient to control his or her own breathing. This allows the patient to take as many breaths as needed, and the machine helps to give the right size breath.

How long will the patient be on the breathing machine?

It is often difficult to predict how long a patient will need the breathing machine. It will depend on several factors, including:

• The nature and severity of the medical problem that led to the respiratory failure;
• The general condition of the patient before the respiratory failure;
• If any new complications have emerged after the patient went on the breathing machine.

Members of the ICU team may be able to give you their "best informed guess" of the duration of mechanical ventilation, but keep in mind that this estimate may change as the patient's condition evolves.

What conditions need to be met before the patient can be taken off the breathing machine?

Before mechanical ventilation is stopped, three conditions usually need to be met:

• Patients need to be awake enough to start each breath (their brain must tell them to breathe consistently) and to cough properly;
• Patients need to maintain acceptable levels of oxygen and carbon dioxide with minimal help from the breathing machine. This indicates that they are likely to be able to breathe without the machine;
• The medical problem that led to the need for the breathing machinemust have improved significantly. This may be relatively easy to assess if the initial problem was related to just the lungs. But it may be harder to determine if the problem was related to something else such as airway swelling or generalized severe weakness.

How do we know if a patient is getting better?

Several signs can indicate that a patient is getting better during an episode of respiratory failure:

However, the amount of oxygen, suctioning, and pressure may vary quite a bit from hour to hour. So, it may be difficult to determine if the patient is truly getting better by looking only at the numbers.

The bedside nurse, and ICU Doctor will be best able to tell you if any of these changes indicate a real improvement.

What are the risks of being on the breathing machine for a long time?

Like any medical intervention, the breathing machine may cause certain complications. Long periods of mechanical ventilation can be associated with:

• Mouth, vocal cords and throat injuries;
• Lung infections;
• Muscle and general weakness and fatigue, including a lack of strength to breathe independently.

Although many of these complications are treatable and reversible, others can present challenges. For example:

• A lung infection (pneumonia) can sometimes cause other organs to fail, and may become life-threatening;
• Long inactivity can delay patient recovery for weeks or months, characterised by alternating periods of improvement and deterioration.

How is pain assessed?

Patients may experience pain and discomfort while in the intensive care unit (ICU).

• Preventing and relieving pain are top priorities of the health-care team.
  • If a patient can talk, point, or nod his or her head, nurses will use a tool called the Numeric Rating Scale and Face and FLACC(Face, Legs, Activity, Cry and Consolability ) scores for children.
• Because of your personal knowledge of the patient, you may be better able to recognize facial expressions and behaviours that indicate pain. If you think your loved one is in pain, please discuss this with the nurse.

What can be done for patients who can’t communicate?

Many patients in the ICU are unable to talk, point, or nod their head for some part of their ICU stay.

• For these patients, nurses use another tool that considers facial expressions and other behaviours that indicate pain
• If pain is present, pain-relieving medications will be given
• Other strategies to relieve pain include positioning and massage.

How often is pain assessed?

Nurses assess for pain every 1 to 4 hours and more often if needed.

How is difficult-to-treat pain managed?

• Sometimes it can be difficult to completely relieve pain. The team may try different combinations of drugs to be successful
• A specialist pain team can provide additional advice to the ICU team
• Some drugs that help treat pain may cause sleepiness.

What is delirium?

Delirium is a common condition among hospitalised patients, especially those in the ICU. Patients with delirium may have the following symptoms:

• An inability to focus and maintain attention, which typically fluctuates over the course of the day;
• Can't think clearly or remember recent events;
• Disoriented, forgetful, and can't express themselves clearly;
• Very sleepy or very agitated;
• May see or hear things that do not exist (visual or auditory hallucinations);
• May not recognise their family members or may be convinced that the hospital staff wants to harm them.

The ICU team is regularly looking for signs of delirium among ICU patients. However, family members are encouraged to notify the team if they observe that their loved one is not behaving as usual.

What causes delirium?

Unfortunately, we do not fully understand why some patients develop this state of confusion. But many ICU patients are particularly vulnerable. The following conditions may increase the risk of delirium:

• Conditions affecting the brain such as a stroke, head trauma, Parkinson's disease and dementia;
• Advanced age;
• Hearing or visual impairment.

In addition, other complications or treatments required for the care of ICU patients may contribute to a state of confusion, including:

• Use of multiple medications;
• A surgery;
• An infection;
• Use of a bladder catheter.

What can be done to help delirium?

Both the ICU team and family members can help with the prevention of delirium by making the ICU environment feel a little more normal. These measures include:

• Limiting noise and light at night to favour sleep;
• Getting patients out of bed when possible;
• Re-orienting patients so they are aware of the time of day, where they are and who are the people around them;
• Limiting the use of catheters and physical restraints;
• Providing enough, but not too much stimulation;
• Treating pain appropriately;
• Providing hearing aids and eyeglasses to the patients who need them.

What can be done to treat delirium?

• There are no magical pills or tricks to treat delirium;
• The calming measures used to help prevent delirium are also used to bring it to the end;
• Certain medications may be used to control the agitation of some patients when they are at risk of injuring themselves or others.

When will the delirium be over?

• Delirium can last hours, days, weeks or even months;
• It is often the last thing to improve once the other medical conditions have resolved;
• Even when the symptoms of delirium appear to have resolved, patients and family members may continue to notice changes in memory or ability to complete certain daily tasks.

What can cause an acute brain injury?

The brain can be injured for different reasons, the most common causes include:

• Trauma to the head;
• Blockage of a blood vessel to the brain;
• Bleeding into or around the brain;
• The after-effects of when the heart stops during a cardiac arrest.

The team looking after your loved one will be able to explain what caused the brain injury.

Why does a brain injury make patients critically ill?

Sometimes a brain injury can damage a vital area of the brain or involve such a large part of the brain that it places a patient’s life in danger. When patients become this ill because of their brain damage, symptoms may include:

• Unable to stay awake;
• Can’t breathe properly;
• Can’t regulate the proper level of blood pressure.

So far, modern medicine has not found any specific medications or procedures that can repair these damaged brain cells. Unfortunately, once the damage has been done, it cannot be reversed. However, in the right environment the brain does have the potential to recover and adapt to the existing brain injury.

• In the ICU, focus is placed on preventing further damage to the brain that may result from swelling around the injury, not enough blood to the brain or further bleeding into the brain;
• To create the best possible environment for the brain to recover, the patient’s breathing and blood pressure are regularly monitored to make sure blood and oxygen are flowing properly to the brain;
• Detailed neurological clinical exams are done regularly to detect deterioration in brain function, so the team can act quickly to stop any further damage.

What is done if the brain starts to further deteriorate?

• Medications may be used to help reduce pressure that builds up around the brain from the swelling or bleeding;
• If there are large collections of blood that are increasing the pressure on the brain surgery maybe required;
• A part of the skull may be removed to further relieve the pressure.

How long will it take the brain to recover?

• Just as no two people are alike, no two brain injuries are the same. This can make it hard to provide an accurate estimate of just how much your loved one will recover and how long it will take;
• Other factors that will affect this recovery process include the age of your loved one, and any previous medical problems.

In general, a patient can continue to improve for up to 2 years. However, much of the recovery takes place in the first 6 months. With a severe brain injury, a patient may suffer life-changing and debilitating problems including mental, behavioural, and physical disabilities.

Infections are a common reason for patients to be admitted to an intensive care unit. But, unfortunately, patients can also pick-up new infections while they are in the ICU. ICU patients are vulnerable to infection for several reasons:

• The immune system does not function normally during critical illness. So, the body’s natural defences are not working properly
• Invasive devices – such as needles and tubes – are put into the body as part of the regular treatments of the ICU. These devices bypass the body’s normal defences such as the outer layers of skin

Invasive treatments that may increase the risk of infection include:

• Airway intubation to assist breathing
• Intravenous (IV) lines to administer medications
• Urinary Catheter (IDC) to drain the bladder.

At any given time, about half of ICU patients are being treated for some type of infection. The most common ICU infections include:

• Ventilator-associated pneumonia (related to being on a mechanical ventilator for breathing support)
• Central line-associated bloodstream infection (related to the intravenous lines)
• Catheter-associated urinary tract infections (related to the urinary or Foley catheters)
• Surgical site infections (related to surgeries undergone before or during ICU stay)
• Clostridium difficile infection (a bowel infection that can happen after antibiotic use)
• Vomiting and diarrheal illness.

The teams also use other measures to keep infections in check. You might have noticed some of these approaches in the ICU, such as:

• Keeping the head of the bed raised above 30 degrees to lower the risk of ventilator associated pneumonia
• Special sterile techniques to insert intravenous lines to prevent line-associated infections
• Avoiding unnecessary over treatment with antibiotics, because this can lower the risk of Clostridium difficile and reduce the emergence of new antibiotic resistant bugs.
• Infection and Prevention protocols and policies for example 5 moments of Hand hygiene.

For those patients who get an infection in the ICU, the treatment usually includes:

• A course of targeted antibiotic medication
• In some cases, certain measures can help control the source of infection, such as draining an abscess or removing an infected intravenous line.

It is important to have as healthy an environment as possible. To reduce the spread of germs, we ask you to:

1. Stay home when you are sick
2. Clean hands using alcohol-based hand rub before and after your visit
3. Don’t bring in pets
4. Eliminate or minimise the number of personal belongings you are bringing to a visit.

My loved one is having a prolonged ICU stay

Some illnesses leave patients in need of our care for a long period of time. Being in ICU for a prolonged stay comes with added challenges for patients and their whānau.

Can we bring in some of our loved one’s belongings?

If your loved one is having a long stay in ICU, you may wish to bring in a few things to display in their room. We encourage families to bring in photos, or special items if they wish. Toiletries from home as always nice.

How can we keep track of everything that has happened during our loved one’s ICU stay?

We can provide you with a Patient Diary that you may use to document your loved one’s ICU journey. The ICU staff may also write in it about what occurred during their shift.

This diary can help when patients are rehabilitating down the line. It can help them piece together each part of their recovery.

If you are interested in this and it has not already been offered to you, please mention it to your nurse or social worker.

Why is my loved one so weak?

People who are bedridden, even for only a few days, quickly lose strength and muscles mass. For very sick patients, this loss of strength can be even quicker.

We don’t completely understand why this happens so quickly in very sick patients, but we do know that the longer patients stay in bed, the worse and more persistent the weakness becomes.

What can be done to prevent weakness?

There are things that can be done to prevent or minimise muscle weakness. They include:

• Rehabilitation which can start even when the patient is still on a mechanical ventilator;
• Minimise time in bed;
• Even simple tasks, such as sitting at the edge of the bed, can help to reduce weakness;

My loved one is getting ready to go to the ward.

As this day approaches, you’ll notice the nursing staff may step back a bit.  This is purposeful and is to help your loved one get used to being on their own again. The wards can be a busy place and your loved one’s nurse will have other patients to care for.  Leaving ICU after a long stay and one on one nursing can feel daunting so a gradual transition works best.  But don’t panic – someone is always keeping an eye out for your loved one.

Please respect any COVID visiting restrictions if they are in place, this is directed by the Ministry of Health. If you visit, we will provide you with information regarding any restrictions, such as needing to wearing a medical mask.

Usually, we have no restrictions on visiting hours in ICU Waipapa. Who can visit is determined by the patient/tūroro and family/whānau,however there are times when visiting a patient is not possible such as when they are receiving medical care from staff.

Children are welcome in the ICU to visit immediate relatives, such as grandparents, parents and siblings. A visit can be helpful for both the child and the patient. But do not bring children who have a contagious illness such as a cold or the flu, because this puts the patient at risk.

 Please talk to the bedside nurse who can coordinate a discussion about options available with our Social Worker.

Te Whare Mahana is both one bedroom and marae style accommodation for whānau support persons who reside outside the Canterbury region, and open to all cultures. Please ask the Māori Health worker for further information about this accommodation. 

Ask the bedside nurse looking after your loved one, they can assist with this and connect you to the right person.

Chaplains and spiritual advisors

The hospital chaplains have been theologically and clinically trained and licensed to work in a hospital.

The chaplaincy team offers confidential compassionate support, prayer, and a listening ear in times of stress or loneliness; before and after surgery; for people experiencing loss and bereavement and around matters of faith and illness; and in celebrating the joys of life. They are available for prayer and church sacraments.

Many hospitals have an interfaith chapel, or a quiet place for prayer and reflection.

The chaplains are available to people of all faiths and no faith, and are here to support people of all religions and cultures. They can also contact your own religious or spiritual advisor and ask them to visit (Jewish, Hindu, Muslim, Buddhist, etc.).

Arrange a visit from a chaplain

Your nurse, social worker, ward clerk or doctor can arrange for a chaplain to visit you, or you can ask to speak with a chaplain when you see them in the ward.

Further information about how to contact a chaplain directly is in our patients and visitors section.

Blessing, rituals and ceremonies

Hospital chaplains provide appropriate blessing rituals for patients, their families and staff. This includes blessing rooms after death, equipment, wards, and workplaces.

There is a quiet space on level one of the Waipapa building. This is an interdenominational space for all people to use. Please note: no food is allowed in this space.

Few people are prepared for their loved one’s critical illness or injury. It is usually an experience involving a flood of emotions, including fear, anxiety, anger, exhaustion, frustration and loss of control.

These feelings are all normal, and many family members have described it as an ‘emotional roller coaster ride’. But it’s important to keep in mind that taking good care of the patient involves taking good care of yourself.

To manage your feelings, and cope with the situation, you may want to consider the following:

• Make sure that you eat properly, get enough rest and take care of your personal needs.
• Some families are reluctant to leave the hospital, fearing that their loved one could take a turn for the worse when they are away. If you are not sure it is an appropriate time to leave, talk it over with the bedside nurse or other team members. They will let you know if they feel you need to stay.
• Think about what other help might be available to you. That might involve reaching out to family and friends, hospital support staff, clergy and other members of the community. They might be able to help you with emotional and practical support, such as bringing you homemade meals, helping with child care, or transportation needs.
• Some families find that sending emails to a list of people can help update others about the patient’s condition and reduce the need for many telephone conversations.
• It is common for some visitors to feel uncomfortable in the ICU. If you feel in any way lightheaded, make sure that you find a seat and let someone know you are not well.

ICU waiting room

The ICU waiting room has tea and coffee making facilities. This room is shared with other whānau.

Quiet room

The quiet room is available for visitors who wish to have some quiet time to reflect on things. Please note: There is no eating and drinking allowed in the quiet room.

Toilets

Toilet facilities are located to the right outside of the waiting room.

Telephones

Please let us know if you need to contact whānau or close friends outside Ōtautahi Christchurch and we may be able to assist.

Cafes

There are several cafe's at Christchurch Hospital – Peaberry and Willow Lane are located on the ground floor of the Waipapa building, and the Great Escape Café is located on the 3rd floor of the Food Services building, Parkside West. Cafés have meals, snacks and hot drinks available, there are also snack and cold drink vending machines located around the hospital.

You should expect to pay for car parking as there are very few free car parks near the hospital.

Hospital shuttle bus

The popular Christchurch Hospital shuttle service runs every 15 minutes from the Deans Avenue Park and Ride Car Park. The car park is a 15-20 minute walk, or a 5-10 minute free shuttle bus ride from hospital.

Parking on-site

There is very limited premium metered car parking in front of the Emergency Department outside the Waipapa building. This is the only public car parking available on-site, and we encourage using this only for emergencies and patient drop-off and pick-up. We recommend that drivers use different nearby car parks or the Deans Avenue Park and Ride Car Park if they need to park longer than 30-60mins.

The first  30 minutes of parking is free (note: your license plate number must be entered into the parking meter to get 30 minutes free) . After 30 minutes the following charges will apply:

• 30-60 minutes: $7.50
• From 60 minutes onwards: additional $5 per half hour or part thereof ($80 maximum charge for a 24-hour period).

There are also a number of P180 mobility parks in this area. These parks are free for mobility permit holders.

 NEW//   Nearby car parking – Tū Waka-Waipapa Public Car park

Tū Waka-Waipapa is a new 463-space car park, located at the corner of St Asaph Street and Hagley Avenue, a 4-5 minute (300 metre) walk from Christchurch Hospital.

Parking charges:

From 13 May 2024 onwards – new Early Bird rate 

• If you enter between 6am-9am and exit between 2.30pm-8pm – $15.00
• 7 days a week

Casual Day rate

• First 20 Minutes – Free
• 21-60 Minutes – $6.00
• Per half hour or Part Thereof/Thereafter – $3.00
• Maximum daily charge – $24.00

New day starts at 5:00am. Monday – Sunday

Night rate

• Entry after 4pm, valid until 8am the following morning – $10.00

About the Tū Waka-Waipapa car park:

• 463 parking spaces including mobility parks.
• Open 24/7 with no limits on parking times.
• Car park users pay for parking at the lobby through pay stations using cash or eftpos.
• There are bike racks on the ground floor for cyclists to use for free.

Tū Waka-Waipapa car park is managed by Wilson Parking on behalf of Ngāi Tahu Property. More information can be found at www.wilsonparking.co.nz

On-street parking and other car parks

There is limited car parking near Christchurch Hospital including on-street metered parking and paid parking lots in surrounding streets. You can check CCC Parking Map to view many parking options nearby the hospital.

Car parking advice

• When travelling to hospital we recommend that you allow extra time to park and to get to an  appointment.
• There is a recorded 0800 phone number for the very latest parking information, call 0800 555 300.
• Other privately operated metered car parks are available within the vicinity of Christchurch Hospital.

Wi-fi access for your tablet or mobile phone is free and available to all patients and visitors. Wi-Fi set-up instructions are available in the patients and visitors section of this website.

Current detailed COVID visiting guidelines are listed below.

Some visitor restrictions for all Health New Zealand | Te Whatu Ora Waitaha Canterbury hospitals and health facilities remain in place, but we have relaxed others.

There is still a heightened risk to vulnerable people in hospital and we encourage all people wear a mask when visiting any of our facilities and follow other advice designed to keep patients, staff and visitors safe.

To keep everybody safe:

• Visitors or support people are advised to not visit our facilities if they are unwell. We advise that you do not visit if you have recently tested positive for COVID-19 and haven’t completed your isolation period.
• Patients may have more than one visitor, except in some situations such as multi-bed rooms where it can cause overcrowding.
• Surgical/medical masks are encouraged to be worn at all sites. Masks will be provided if you don’t have one.
• Please practice hand hygiene with provided alcohol-based hand rub/gel

Thank you in advance for your patience and understanding as our staff work hard to protect and care for some of the most vulnerable in our community.

Visiting patients with COVID-19

• People can visit patients who have COVID-19 but they must wear a surgical mask as a minimum – please use surgical masks provided.

All of our Hospitals

Visiting hours for our hospitals have returned to pre COVID-19 hours.

All visitors are encouraged to wear a medical face mask.

Parents/caregivers can be with their child in hospital and visitors are now allowed, except for the Children’s Haematology and Oncology Day stay where visitor restrictions might apply.